The experience of rape, defined as unwanted sex obtained by force, threat, or the assault of a victim incapable of consenting, remains a major public health problem affecting women. Recent surveys of college women, for example, have found that between 15 and 20% have experienced rape by a man or men during their adolescence or adulthood (Kahn, Jackson, Kully, Badger, & Halvorsen, 2003; Littleton & Radecki Breitkopf, 2006; Schwartz & Leggett, 1999). The experience of rape is associated with high levels of psychological distress, including the development of posttraumatic stress disorder (PTSD), depression, and anxiety (e.g., Boudreaux, Kilpatrick, Resnick, Best, & Saunders, 1998; Breslau et al., 1998; Kessler, Sonnega, Bromet, Hughes, & Nelson, 1995).
The majority of college rape victims do not label their experience as rape, or even as a victimization (Bondurant, 2001; Fisher, Daigle, Cullen, & Turner, 2003; Frazier & Seales, 1997; Littleton, Axsom, Radecki Breitkopf, & Berenson, 2006), a remarkable finding given the prevalence of this crime, the existence of programs on many college campuses to raise awareness about this problem, and the often significant consequences of rape for victims' psychological well-being. Instead, these individuals conceptualize their experience as a more benign event, such as a miscommunication, seduction, or instance of bad sex, or state that they are unsure how to label the experience (Littleton et al., 2006; Littleton, Radecki Breitkopf, & Berenson, 2008). These individuals have been termed unacknowledged rape victims (Koss, 1989).
Much initial research on rape acknowledgment focused on differences in the assaults experienced by unacknowledged and acknowledged victims. This research has consistently shown that the assaults of unacknowledged victims are less violent than those of acknowledged victims, involving less force, resistance, and injury (Bondurant, 2001; Botta & Pingree, 1997; Kahn et al., 2003; Layman, Gidycz, & Lynn, 1996; Littleton et al., 2006). In addition, they are more likely to occur in the context of a romantic relationship (Frazier & Seales, 1997; Kahn et al., 2003; Koss, 1985; Koss, Dinero, Seibel, & Cox, 1988) and to involve alcohol use by the victim and assailant (Bondurant, 2001; Botta & Pingree, 1997; Layman et al., 1996; Littleton et al., 2006; Schwartz & Leggett, 1999). These assault characteristic differences have led to the hypothesis that many rape victims do not label their experience as such because it is inconsistent with their rape script, or set of event-related ideas about rape (Kahn, Mathie, & Torgler, 1994; Littleton & Axsom, 2003). Indeed, studies of individuals' rape scripts supports that these scripts often involve a highly violent stranger assault (Littleton & Axsom, 2003; Littleton, Radecki Breitkopf, & Berenson, 2007; Ryan, 1988). In addition, unacknowledged victims have been found to be significantly more likely than acknowledged victims to hold this violent rape script (Bondurant, 2001; Kahn et al., 1994).
More recently, researchers have begun to focus on the implications of victims' acknowledgment status on their postassault experiences, theorizing that how victims conceptualize their rape experience has implications for how they think, feel, and behave afterward. Indeed, logically it would be expected that women who believe that they have been victimized will act in a manner consistent with that conceptualization (e.g., feel distressed, seek out help from others). Conversely, individuals who conceptualize their experience as a more benign event, such as a miscommunication, are likely to behave consistently with that conceptualization (e.g., minimize the severity of the experience, avoid disclosing the experience to others). Individuals' sexual scripts (e.g., rape, seduction) have been found to contain information about how these experiences affect people and how individuals should feel and behave afterward (Littleton & Axsom, 2003; Littleton et al., 2007). For example, it would be expected that victims who conceptualize their experience as a victimization would regard their experience as a more serious stressor than victims who conceptualize their experience as a non-victimizing experience and thus would engage in more extensive coping efforts (given the amount of coping resources devoted to a stressor depends on how serious one appraises the stressor as being). In another example, because of negative beliefs held about rape victims (e.g., that they are weak, vulnerable, and permanently damaged), individuals who regard themselves as a rape victim may be more likely to feel stigmatized than victims who do not regard themselves as a victim. In addition, victims who conceptualize their experience as a rape may be more likely to disclose that experience to others than unacknowledged victims, because disclosure is regarded as a normative and healing response following victimization (e.g., Littleton & Axsom, 2003). Finally, because acknowledged victims likely describe their experience to others as a victimization, it may be likely that the persons to whom they disclose respond by becoming upset or angry. In contrast, because unacknowledged victims likely describe the experience as a more benign event when they disclose, it may be less likely that the individuals to whom they disclose experience a strong emotional reaction to the disclosure.
The most comprehensive study examining the implications of acknowledgment status for victims' postassault experiences was conducted by Littleton and colleagues (2006). Differences in coping, disclosure, and disclosure reactions were examined among a sample of acknowledged and unacknowledged college rape victims after statistically controlling for group differences in assault characteristics and posttraumatic symptoms. Consistent with hypotheses, acknowledged victims reported engaging in more rape-related avoidance coping. Differences in avoidance coping among unacknowledged and acknowledged victims are particularly notable given that individuals are theorized to turn to avoidance strategies when they appraise a stressor as overwhelming their coping resources (Snyder & Pulvers, 2001). In addition, acknowledged victims were more likely than unacknowledged victims to have disclosed and to report that individuals to whom they disclosed became very upset or angry. In a subsequent study, Littleton and colleagues (2008) examined disclosure, disclosure reactions, and stigma among a low-socioeconomic status sample of unacknowledged and acknowledged rape victims. As in the college sample, acknowledged victims engaged in more disclosure behavior than unacknowledged victims. Acknowledged victims also reported greater feelings of stigma about being a rape victim. Although there were no differences in receipt of egocentric reactions (e.g., becoming upset or angry) upon disclosure among unacknowledged and acknowledged victims, it should be noted that this latter study had limited power to detect differences between victim groups on this variable.
The limited research regarding differences in the postassault experiences of unacknowledged and acknowledged victims conducted thus far suggests that not acknowledging rape may, at times, be beneficial to victims, protecting them from engaging in maladaptive avoidance coping, experiencing feelings of stigma, and perhaps receiving harmful disclosure reactions. However, it seems likely that not acknowledging rape may have costs to the victim as well. For example, because unacknowledged victims are less likely to disclose and may describe their experience to others as a more benign event when they do disclose, they may be deprived of supportive reactions. Another critical potential cost to not acknowledging rape may be an elevated risk of further sexual victimization. Because unacknowledged victims conceptualize their experience as a less serious event than acknowledged victims, they may be less likely than acknowledged victims to change behaviors that place them at risk for victimization (e.g., drinking alcohol, using sexual activity to regulate affect, associating with the assailant). Unacknowledged victims may also have more difficulty recognizing and responding to potentially risky sexual situations, given that they do not conceptualize their own assault as a victimization. Several studies suggest that unacknowledged victims may be at elevated risk of revictimization relative to acknowledged victims. For example, Marx and Soler-Baillo (2005) found that unacknowledged victims waited longer to leave a hypothetical date rape scenario than acknowledged victims, suggesting they may have more difficulty recognizing risky sexual situations. In addition, McMullin and White (2006) found that, among college women, unacknowledged victims reported more current alcohol use than nonvictims, whereas acknowledged victims reported similar levels of alcohol use to nonvictims. Finally, Hammond and Calhoun (2007) found that unacknowledged victims were less likely to report engaging in behaviors to try to prevent future assaults than acknowledged victims.
Given suggestive evidence that not acknowledging rape may be associated with elevated revictimization risk, the present study sought to examine differences in revictimization risk behaviors among a sample of acknowledged and unacknowledged victims. In addition, differences in rates of sexual revictimization among unacknowledged and acknowledged victims over the course of 6 months were examined. We hypothesized that unacknowledged victims, as compared to acknowledged victims, would be more likely to report engaging in behaviors that have previously been associated with revictimization risk, specifically alcohol use and using sex to reduce negative affect (Merrill et al., 1999; Messman-Moore & Long, 2002; Orcutt, Cooper, & Garcia, 2005; Van Bruggen, Runtz, & Kadlec, 2006). In addition, we hypothesized that unacknowledged victims would be more likely to report a sexual victimization and would report more alcohol use and using sex to reduce negative affect at a 6-month follow-up assessment. Thus, this study expands prior research by focusing on revictimization risk behaviors as well as actual sexual revictimization among unacknowledged and acknowledged victims.
A total of 1,744 women, recruited from the psychology department participant pools of three southeastern universities, participated for course credit during two academic semesters (Fall 2006 and Spring 2007). A total of 353 women, 20.2% of the sample, responded positively to a screening questionnaire assessing sexual assault experiences in adolescence or adulthood. Of these women, 13 (3.7%) changed their responses to the sexual assault screening items and had extensive missing data; they were eliminated from analyses. Of the remaining 340 participants, 334 (98.2%) indicated their acknowledgment status and constituted the current sample. Participants were 21.7 years of age on average (SD= 5.6, range 18–54 years). Seventy-four percent characterized their ethnicity as European American, 8.4% as Latina, 6.6% as Black or Caribbean Islander, 6% as Asian or Pacific Islander, 2.4% as multi-ethnic, 0.6% as Native American, and 1.8% did not indicate their ethnicity.
Participants from the three universities differed in the percentage of women who self-identified as ethnic minorities, χ2(2) = 31.10, p < .001 (u1 = 24.2%, u2 = 45.2%, u3 = 14.0%). Participants also differed in their mean age, F(2, 333) = 34.14, p < .001 (u1 = 23.4 years, u2 = 24.3 years, u3 = 19.4 years). However, there were no significant differences in the percentage of women at each university reporting a sexual assault experience, χ2(2) = 2.95, p= .229 (u1 = 18.7%, u2 = 22.3%, u3 = 18.6%).
Data were collected using an online survey. Potential participants were recruited using posted flyers and announcements on psychology department research participant management Web sites at the three universities. Posted information stated that participants would be asked to complete a confidential survey about their negative sexual experiences, coping, and psychological health. Participants were excluded if they were male or under 18 years of age. Some form of student identification was collected to award course credit and to prevent duplicate participation (student identification information was removed from the data files prior to downloading).
Participants were given a brief description of the study and information about available counseling resources and asked to provide their electronic consent. Behaviorally specific screening questions were used to determine if participants had an experience in adolescence or adulthood that would meet a legal definition of rape or sexual assault. Participants who endorsed having had a sexual assault experience were asked several questions about the circumstances of their “experience with unwanted sex” (or the one they regarded as the most serious if they had experienced multiple victimizations). They were also given eight potential labels for the assault and asked to choose one: rape, attempted rape, some other type of crime, miscommunication, seduction, hook-up, bad sex, and not sure. Those who did not label the assault as a victimization (i.e., rape, attempted rape, or another crime) were considered unacknowledged. Victims also completed several measures related to their postassault experiences, including their posttraumatic stress symptoms. All screened participants completed measures of their current psychological distress (symptoms of depression and anxiety), alcohol use, and use of sexual activity to reduce negative affect.
Sexual assault victims were asked to provide up to two e-mail addresses to complete a follow-up survey in 6 months. Six months after completing the initial survey, participants who provided an e-mail address were sent an e-mail inviting them to complete the follow-up survey. Participants received up to four e-mail reminders, sent weekly. The follow-up survey assessed sexual victimization experiences that had occurred in the past 6 months and revictimization risk behaviors over the past 6 months. Participants received a $20 Amazon.com gift certificate for completing the follow-up survey. The study was approved by the institutional review boards of the three universities and followed the guidelines for ensuring the confidentiality of online data outlined by Reips (2002).
Victimization items Two behaviorally specific screening items to assess experiences of rape or sexual assault since the age of 14 derived from the Sexual Experiences Survey (SES; Koss & Gidycz, 1985) were administered in the initial survey. The items were developed to be consistent with the definitions of rape and sexual assault in the Commonwealth of Virginia and the State of Texas, where the research was conducted. The items assessed experiences of unwanted sex with a man or men (vaginal, oral, anal intercourse, or object penetration) obtained by force or threat of force, or that occurred when the individual was incapacitated or unconscious, such as from alcohol or drugs.
At the 6-month follow-up assessment, participants completed the same screening items regarding experiences of rape or sexual assault that occurred in the past 6 months. Two additional behaviorally specific screening items from the SES (Koss & Gidycz, 1985) were also administered to assess experiences of attempted rape over the past 6 months. These items assessed instances of attempted sexual assault that occurred following force or threat of force, or when the individual was incapacitated or unconscious, such as from alcohol or drugs.
Assault characteristics questionnaire Participants completed a questionnaire regarding the circumstances of their sexual assault experience. This questionnaire was based on one developed by Littleton and colleagues (Littleton et al., 2006). Three variables were constructed regarding the types of force participants reported that the assailant used from a list provided: verbal threats, moderate physical force (using his superior body weight, twisting your arm or holding you down), and severe physical force (hitting or slapping you, choking or beating you, showing or using a weapon). Three resistance variables were constructed regarding the types of resistance strategies participants reported using from a list provided: nonverbal resistance (turned cold, cried), verbal resistance (reasoned or pleaded with him, screamed for help), and physical resistance (ran away, physically struggled).
Participants were asked to indicate their relationship with the assailant at the time of the experience of unwanted sex from a list provided. Their relationship with the assailant was coded as romantic (dating casually, steady date, romantic partner) or nonromantic (stranger, just met, acquaintance, friend, relative). In addition, each participant estimated the number of standard drinks both she and the assailant had consumed prior to the assault (coded as binge drinking if four standard drinks by the participant, five standard drinks by the assailant; National Institute on Alcohol Abuse and Alcoholism, 2006). Participants also indicated how many times they had experienced unwanted sex with the index assailant (coded as single or multiple) and how many times they had experienced unwanted sex with other men (coded as having occurred or not having occurred). Participants were also asked to estimate how many months ago the assault had occurred. Finally, participants indicated whether they continued their relationship with the assailant after the index assault.
PTSD Symptom Scale (PSS) The PSS (Foa, Riggs, Dancu, & Rothbaum, 1993) is a 17-item measure designed to assess symptoms of posttraumatic stress. In the current study, for each item, individuals rated how often they had the described symptom in the past week in relation to their experience of unwanted sex on a 4-point Likert scale anchored by 0 (not at all or only one time) and 3 (five or more times per week/almost always). A sample item is “Having bad dreams or nightmares about the event.” Scores can range from 0 to 51, and a cutoff of 14 or above on this measure indicates clinically significant PTSD symptomatology (Coffey, Gudmundsdottir, Beck, Palyo, & Miller, 2006). Cronbach's alpha for the scale in a sample of rape victims was .93 and in the current study was .90. The PSS was found to have a sensitivity of 62% and specificity of 100% for a diagnosis of PTSD when compared with a structured clinical interview (Foa et al., 1993).
Center for Epidemiologic Studies Depression Scale (CES-D) The CES-D (Radloff, 1977) is a 20-item, self-report measure primarily of the affective component of depression. For each item, individuals indicated how often they have felt that way in the past week on a 4-point Likert scale bounded by 0 (rarely or none of the time/less than one day) and 3 (most or all of the time/5–7 days). A sample item is “I had crying spells.” Scores can range from 0 to 80, and scores of 16 or above indicate significant depressive symptomatology (Radloff, 1977). Cronbach's alpha for the measure in community and patient samples have ranged from .84 to .90, and the 4-week test-retest reliability was found to be .67 (Radloff, 1977). In the current study, Cronbach's alpha for the measure was .89. Supporting the validity of the measure, scores have been found to correlate moderately to strongly with other clinician-administered and self-report measures of depression and to be sensitive to changes in depressive symptomatology following treatment (Weissman, Sholomskas, Pottenger, Prusoff, & Locke, 1977).
Four Dimensional Anxiety Scale (FDAS) The FDAS (Bystritsky, Linn, & Ware, 1990) is a 35-item, self-report measure of the affective, cognitive, behavioral, and physiological components of anxiety. For each item, individuals indicated how often they have felt in the described manner in the past week on a 5-point Likert scale bounded by 1 (not at all) and 5 (extremely). A sample item is “Trembling or shaking?” Scores can range from 35 to 175. Cronbach's alpha of the measure in both a treatment-seeking sample and in a community sample was .92 (Bystritsky et al., 1990; Stoessel, Bystritsky, & Pasnau, 1995) and in the current sample was .94. Supporting the validity of the measure, individuals seeking treatment for anxiety disorders scored significantly higher on the measure than individuals recruited from a medical setting (Stoessel et al., 1995).
Alcohol Use Disorders Identification Test (AUDIT) The five-item version of the AUDIT (Babor, Higgins-Biddle, Saunders, & Monteiro, 2001; Miles, Winstock, & Strang, 2001) was administered to assess participants' alcohol use. This measure assesses potentially hazardous alcohol consumption (Miles et al., 2001). A score of 5 or above on this measure indicates hazardous use (Miles et al., 2001). A sample item is “How often during the past year have you found that you were not able to stop drinking once you had started?” In the current study, Cronbach's alpha of this measure was .77. The AUDIT was found to have a sensitivity of 79% and a specificity of 95% for alcohol dependence and harmful use as compared to a structured clinical interview (Piccinelli et al., 1997). For the follow-up assessment, the items assessed alcohol use over the past 6 months. It should be noted that 6.9% (n= 23) of the sample reported no past-year alcohol use and did not complete this measure at the initial assessment, and 8.6% (n= 9) of the sample reported no alcohol use over the 6-month follow-up period and did not complete this measure at follow-up.
Use of sex to reduce negative affect This four-item measure is designed to assess use of sexual activity to reduce negative affect (Orcutt et al., 2005). In the current study, participants were first asked whether they had engaged in sexual activity over the past year (6 months in the follow-up survey), including kissing and petting, and to estimate the number of partners they had in the past year (6 months in the follow-up survey). Participants who reported engaging in sexual behavior were then asked to indicate how often they had engaged in sexual activity, including kissing and petting, for the listed reasons on a 5-point Likert scale anchored by 1 (almost never/never) and 5 (almost always/always). Scores can range from 4 to 20. A sample item is “To feel better when feeling low.” Cronbach's alpha among a community sample was .81 and in the current study was .92. At the follow-up assessment, participants completed the items regarding their sexual behavior over the past 6 months. It should be noted that 2.1% (n= 7) of participants did not report engaging in any sexual activity in the past year and did not complete this measure at the initial assessment, and 5.7% (n= 6) of participants did not report engaging in any sexual activity over the 6-month follow-up period and did not complete this measure at the follow-up assessment.
Missing data were minimal overall. Missing data ranged from 0% (PTSD symptomatology) to 4.5% (months since assault occurred). Participants with missing data on a particular variable were eliminated from analyses of that variable.
Assault and Demographic Characteristics of Unacknowledged and Acknowledged Victims
Sixty-one percent (n= 203) of the participants in this sample were unacknowledged victims, whereas 39% (n= 131) were acknowledged. Forty-five percent of unacknowledged victims were unsure how to label their experience, 38% labeled it a miscommunication, 9% a hook-up, 5% as bad sex, and 3% a seduction. Sixty-six percent of acknowledged victims labeled their experience a rape, 23% an attempted rape, and 11% as some other type of crime. Consistent with prior research, Bonferroni-adjusted chi square analyses supported that the assaults of unacknowledged victims were less violent, being less likely to involve use of physical force and threats by the assailant and resistance by the victim (Table 1). In addition, unacknowledged victims were more likely to have been binge drinking during the assault. Unacknowledged assaults were significantly more recent overall, t(321) = 5.64, p < .001 (unacknowledged M= 30.2 months, SD= 32.5 months; acknowledged M= 66.8 months, SD= 81.3 months), and were significantly more likely to have occurred within the past year. In contrast, there were no differences in the proportion of unacknowledged and acknowledged victims reporting a romantic relationship with the assailant. In addition, there were no significant differences in the proportion of acknowledged and unacknowledged victims reporting multiple assaults by the index or other assailants. Finally, unacknowledged victims were significantly more likely to continue their relationship with the assailant after the assault.
Characteristics of Unacknowledged and Acknowledged Assaults
|Force by assailant|
| Verbal threats||9.4 (19)||27.5 (36)||19.01*|
| Moderate physical force||55.7 (113)||80.9 (106)||22.49*|
| Severe physical force||2.5 (5)||11.5 (15)||11.42*|
|Resistance by victim|
| Nonverbal resistance||56.2 (114)||66.4 (87)||3.49|
| Verbal resistance||33.5 (68)||51.9 (68)||11.18*|
| Physical resistance||30.5 (62)||56.5 (74)||22.21*|
|Binge drinking by victim||65.5 (133)||38.0 (49)||24.14*|
|Binge drinking by assailant||51.2 (104)||37.2 (48)||6.25|
|Romantic relationship with assailant||37.9 (77)||26.0 (34)||5.15|
|Assault occurred within the past year||40.1 (77)||24.4 (31)||8.41*|
|Multiple assaults by index assailant||16.1 (31)||17.2 (21)||0.06|
|Assaults by other assailants||21.8 (44)||32.8 (42)||4.57|
|Continued relationship with assailant||37.4 (127)||19.8 (105)||11.18*|
Acknowledged victims were significantly older on average than unacknowledged victims, t(330) = 5.91, p < .001 (acknowledged M= 23.8, SD= 7.6; unacknowledged M= 20.3, SD= 3.1). Acknowledged victims (13.0%) were also significantly more likely to be married than unacknowledged victims (4.0%), χ2(1, N= 333) = 9.30, p= .002. However, there were no significant differences in the proportion of unmarried unacknowledged (72.2%) and acknowledged (64.0%) victims reporting that they currently had a boyfriend or partner, χ2(1, N= 308) = 2.23, p= .14.
Distress Among Unacknowledged and Acknowledged Victims
Bonferroni-adjusted t tests indicated that acknowledged victims were significantly more distressed than unacknowledged victims. Acknowledged victims reported greater depressive symptomatology on the CES-D than unacknowledged victims, t(331) = 2.42, p= .02; greater anxious symptomatology on the FDAS, t(332) = 3.04, p < .005; and greater PTSD symptomatology, t(332) = 4.26, p < .005. Acknowledged and unacknowledged victims' scores on these measures are summarized in Table 2.
Distress and Revictimization Risk Behaviors Among Unacknowledged and Acknowledged Victims
|PTSD symptomatology|| 8.7|| 9.2||13.4||10.9||.48*|
|Hazardous drinking|| 6.5|| 3.9|| 5.0|| 3.8||.41*|
|Sex to reduce negative affect||10.5|| 5.0|| 9.8|| 5.0||.15 |
Revictimization Risk Behaviors
Hazardous drinking was common among victims in the initial assessment. Fifty-two percent of victims scored above the cutoff for hazardous use on this measure. Unacknowledged victims scored significantly higher on this measure overall than acknowledged victims, t(308) = 3.47, p < .005. In addition, unacknowledged victims (61%) were significantly more likely to report hazardous drinking than acknowledged victims (38%), χ2(1, N= 334) = 16.0, p < .001. In contrast, there were no differences in use of sexual activity to reduce negative affect between unacknowledged and acknowledged victims, t(323) = 1.36, p= .18, with both groups rarely reporting engaging in sexual activity for this reason. Unacknowledged victims averaged 3.9 partners in the past year (including kissing and petting), and acknowledged victims averaged 3.5 partners in the past year, a nonsignificant difference, t(318) = 0.70, p= .49. Participants' scores on these measures are summarized in Table 2.
Revictimization and Risk Behaviors at Follow-up
A total of 250 women (75%) provided e-mail addresses to be contacted to participate in the follow-up survey. Of these women, 105 (42%) completed the follow-up survey (48 acknowledged victims, 57 unacknowledged victims). Women who completed and those who did not complete the follow-up (either because they did not provide an e-mail address or because they did not respond to the e-mail solicitation) were compared. There were no significant differences between completers and noncompleters on any variables analyzed: age, ethnicity, marital status, relationship status, depressive symptoms, anxious symptoms, PTSD symptoms, hazardous drinking, sex to reduce negative affect, assault characteristics (force, resistance, relationship with assailant, alcohol use during the assault by victim and assailant, time since assault, multiple victimization), and acknowledgment status.
Sexual revictimization was common among participants; 30% of the sample reported experiencing an attempted rape during the follow-up period, and 30% reported experiencing a completed rape during the follow-up period. Unacknowledged victims (39%) were significantly more likely than acknowledged victims (19%) to have experienced an attempted rape during the follow-up period, χ2(1, N= 105) = 4.9, p= .03. In contrast, there were no significant differences in the proportion of unacknowledged (28%) and acknowledged (31%) victims who experienced a completed rape during the follow-up period, χ2(1, N= 105) = 0.1, p= .72.
There were no significant differences in the proportion of unacknowledged (42%) and acknowledged (29%) victims reporting hazardous alcohol use during the follow-up period, χ2(1, N= 105) = 1.90, p= .17. In addition, there were no differences in unacknowledged and acknowledged victims' overall score on the AUDIT, t(93) = 1.51, p= .13, d= .31 (unacknowledged M= 5.3, SD= 4.3; acknowledged M= 4.1, SD= 2.9). There were also no differences in unacknowledged and acknowledged victims' reported use of sex to reduce negative affect, t(97) = 0.26, p= .80, d= .25 (unacknowledged M= 8.7, SD= 4.5; acknowledged M= 8.4, SD= 5.0).
Results of the current study suggest that unacknowledged victims may be at greater risk for experiencing sexual revictimization than acknowledged victims; this represents the first study to identify such differences between the two victim groups. Unacknowledged victims were significantly more likely than acknowledged victims to report experiencing an attempted rape over the 6-month follow-up period and were as likely as acknowledged victims to experience a completed rape. Suggesting at least one possible mechanism for this difference, unacknowledged victims reported more hazardous alcohol use in the initial assessment than acknowledged victims. Indeed, 60% of unacknowledged victims scored above the cutoff for indicating hazardous drinking (Miles et al., 2001). Although there were no differences in reported hazardous drinking between unacknowledged and acknowledged victims at follow-up, we had limited power to detect such differences. For example, the power of the sample size to detect a d= .40 difference between unacknowledged and acknowledged victims (the effect size found at the initial assessment) was only 51%. It is also possible that some unacknowledged victims may have changed their behavior (and perhaps their acknowledgment status) following experiencing further victimization. Indeed, hazardous drinking overall declined among victims at the follow-up assessment. Unacknowledged victims also were significantly more likely to report continuing their relationship with the assailant after the assault, which represents another obvious risk for experiencing more assaults by him. In all, these findings suggest the possibility that unacknowledged victims are less likely than acknowledged victims to change behaviors that place them at risk for revictimization. However, it should be noted that unacknowledged and acknowledged victims did not differ in their use of sexual activity to reduce negative affect. Prior research has investigated this risk behavior in community samples of women (Orcutt et al., 2005), and it is possible that this risk factor may be less relevant to college samples, given the low level of this risk behavior in the sample overall. Alternatively, this risk behavior may not play a role in any potential differential risk between acknowledged and unacknowledged victims.
Similar to prior research examining the assault characteristics of unacknowledged and acknowledged victims, unacknowledged assaults were significantly less violent, involving less force by the assailant and less resistance by the victim. Unacknowledged assaults were also significantly more likely than acknowledged assaults to involve binge drinking by the victim. In contrast to some prior research, unacknowledged victims were not more likely to be romantically involved with the assailant than acknowledged victims. In addition, a much smaller percentage of unacknowledged victims were romantically involved with their assailants than in Koss's (1985) earlier research in which 76% of unacknowledged victims were romantically involved with their assailants. This may reflect the current frequency of casual sexual encounters, such as hook-ups, on college campuses (e.g., Paul & Hayes, 2002; Paul, McManus, & Hayes, 2000).
Interestingly, acknowledged victims in the current sample reported more symptoms of general distress than unacknowledged victims, whereas prior research has generally found few differences in general distress among acknowledged and unacknowledged victims (Frazier & Seales, 1997; Layman et al., 1996; Littleton et al., 2006). In contrast, as in the current study, prior research has fairly consistently found that acknowledged victims report greater symptoms of PTSD (Layman et al., 1996; Littleton et al., 2006). These distress differences are particularly interesting given that prior research has found that PTSD symptomatology among victims predicts revictimization (Messman-Moore, Brown, & Koelsch, 2005; Risser, Hetzel-Riggin, Thomsen, & McCanne, 2006), whereas in the current study, unacknowledged victims, who were significantly less distressed than acknowledged victims, experienced more revictimization. Thus, it is clear that the relations among symptomatology, risk behavior, and acknowledgment status are complex, and perhaps risk pathways may vary between unacknowledged and acknowledged victims.
Limitations of the study should be noted. First, although the study involved a fairly ethnically diverse sample of victims drawn from three universities, the sample was composed of college victims and may not generalize to other groups of victims. In addition, some of the variables were analyzed only at the cross-sectional level, limiting the confidence with which causal inferences can be drawn. Also, only 42% of individuals who agreed to complete the follow-up survey did so. However, it should be noted that there were no significant differences on a number of key variables between individuals who completed the follow-up survey and those who did not complete the follow-up survey. In addition, the follow-up rate was similar to the mean response rate found in a recent meta-analysis of online survey solicitations (40%; Cook, Heath, & Thompson, 2000). Finally, it is possible that differences in revictimization rates among unacknowledged and acknowledged victims may be accounted for by demographic differences between the two groups of victims in the current sample. However, neither age nor marital status, two demographic variables on which acknowledged and unacknowledged victims differed, predicted revictimization (analyses not shown).
Bearing these limitations in mind, the current study has several implications for future research in this area. First, there is a clear need for investigation of revictimization risk among unacknowledged and acknowledged rape victims. The current study provides evidence that sexual assault victims, regardless of how they conceptualize their experience, are at risk for further victimization. In addition, results suggest that unacknowledged victims may be at elevated risk for revictimization as compared to acknowledged victims and that one reason for this elevated risk may be their alcohol use. However, it is likely that other factors contribute to this revictimization risk as well, such as entering risky sexual situations and difficulty recognizing or responding to men's sexual overtures. Future research should also examine the impact of sexual revictimization on victims' acknowledgment status and risk behaviors. Perhaps for some unacknowledged victims, experiencing a revictimization may lead them to reconceptualize their assault as a more serious event and, in turn, to engage in fewer revictimization risk behaviors. Research in these areas will lead to a better understanding of the postassault experiences of all rape victims as well as a better understanding of why revictimization is so common among sexual assault victims.